Florida Public Health Review


Tuberculosis (TB) remains in the crosshairs of many public health policies worldwide that are taking aim at eradicating this potentially curable and preventable illness. Although tuberculosis (TB) incidence has been declining in the United States for over a decade, it still remains a serious public health concern. Currently, there is no public health policy that requires the screening of non-immigrant international university students visiting the United States. Given the rising numbers of visiting international students, this population has come under scrutiny as potential vectors of transmission of TB into the United States. Foreign-born persons from countries with consistently elevated TB prevalence rates constitute an important high risk group for both TB exposure and infection in this setting. Although some universities have their own public health protocols, not all universities have a policy of screening international, non-immigrant students for TB. To further investigate the situation, we reviewed the medical charts of international students visiting the University of Florida. Students who visited the health department for evaluation of TB skin tests from January1998 to February 2002 were studied. Of the students with a positive tuberculin test (skin test >10mm induration), 97.6% had normal chest radiographs. Only 31 students (10.8%) agreed to undergo treatment for latent TB infection (LTBI), of which only half completed a six to nine month course and 86.8% were lost to follow-up. To attempt complete eradication of TB from the United States, universities with at-risk populations should consider the implementation of strict guidelines and well defined policies for the screening, follow-up and treatment of active and latent TB in international students.